Is this perhaps a manifestation of the unequal distribution

Is this perhaps a manifestation of the unequal distribution of growth, reflecting a pattern whereby income increases over the past two decades have benefited only the better-off? The evidence suggests that this is unlikely: across countries, Vollmer and colleagues report similar associations between growth and reductions in undernutrition for the richest and the poorest quintiles of wealth; and the decline in calorie intake noted by Deaton and Dreze for India is evident across income deciles. The order l-name in India between high rates of growth, improvement in several other public-health outcomes, and the continued prevalence of high levels of undernutrition (higher than most sub-Saharan African countries, which are much poorer) has led some prominent scholars to question the very premise of globally uniform growth charts to measure child nutrition. This conclusion is likely to be too pessimistic: as noted in a recent study by Jayachandran and Pande, Indian first-borns are taller than African first-borns and the difference in height-for-age -scores only appears later in the birth order of children; Jayachandran and Pande relate this lag to environmental influences, especially differential investment in children within the household. What can public policy do if sources of undernutrition stem from household choices that rising incomes do not remedy? Clearly, public health and nutritional interventions can have an important role in reducing child undernutrition. Spears documents a clear gradient between sanitation and child undernutrition, large enough to statistically explain excess stunting in India compared with sub-Saharan African countries; in another recent study, my coauthors and I also document that the Indian Midday Meals programme in schools leads to catch-up growth to compensate for drought-related nutritional deprivation in early childhood. Although economic growth alone might not accomplish an end to child undernutrition, proven interventions targeted at nutrition might.
, a fastidious Gram negative bacillus first described by Augusto Ducrey in 1889, is the causative agent of chancroid, a genital ulcer disease common in developing countries. It is a strict human pathogen and there are no known animal or environmental reservoirs. In addition to causing chancroid there is increasing evidence to support its previously unrecognised role as a causative agent of chronic skin ulceration in children from developing countries, in particular South Pacific Island Countries and Territories (PICT). The study by Oriol Mitjà and colleagues in this issue provides further support for as a cause of non-sexually acquired chronic skin ulceration. Earlier evidence was provided by case reports describing cutaneous skin infections in individuals from PICT. These individuals, three children and three adults, were residents of Australia, New Zealand, or a PICT, who reported the onset of the lesion while spending periods of time in a PICT. All, irrespective of age, presented with painful non-healing chronic skin ulcers on their legs. Mitjà and colleagues did a prospective cohort study of five yaws-endemic villages in Papua New Guinea during a yaws elimination campaign. The characteristics of the skin lesions, occurring in predominantly children, were described in detail. Several non-culture-based investigations were used to determine the causative organism including treponemal serology and PCR on lesional exudate using gene targets to detect and DNA. A bacterial cause was identified in 81% of individuals. Surprisingly, was the most common pathogen, with DNA found in 54 of the 73 individuals, either alone (n=42) or in conjunction with subsp DNA (n=12). There is limited data describing the causative agents of infected chronic skin lesions in children and adults in PICT. Lesions typically occur on the legs and are more common in children. A study from the 1980s looking at the bacterial cause of infected skin lesions in children in Papua New Guinea reported “Vincent\'s organisms” ( and ) in almost three-quarters of Gram stains of exudative material collected from tropical ulcers. Other pathogens such as and were also present. However, culture for fastidious pathogens such as anaerobes or was not undertaken.